One of the biggest health threats to people living with chronic hepatitis B is a toxic, nearly invisible mold called aflatoxin found in corn, peanuts, peanut butter, almonds, Brazil nuts, walnuts and pistachios.

People with hepatitis B who eat food with high levels of aflatoxins face a liver cancer risk that is 60-times above average.

In addition to nuts and grains like quinoa, aflatoxin can be found in figs, milk and cheese, soybeans, dried spices and cottonseed. It is less common in rice, as long as rice is hulled, which removes aflatoxin mold.

This toxic mold, produced by a fungus that grows in warm, moist climates, is found at high levels in crops grown in rural regions of sub-Saharan Africa, Southeast Asia and China, where food storage and processing is not closely regulated. Unfortunately, these regions also have high rates of hepatitis B infection.

Low levels of aflatoxins are considered unavoidable in food and animal feed, even when good manufacturing practices are followed. Most countries, including the U.S., allow low amounts of aflatoxin in corn and peanuts. However, some researchers suggest even these low levels can lead to liver damage in people infected with hepatitis B who rely on diets rich in corn, nuts and grains. Click here to read the rest of this article, including some ways you can limit the amount of aflatoxin in your diet.

This article originally appeared in the Hepatitis B Foundation’s Hep B Blog; permission to reprint granted.